Provider Demographics
NPI:1407049083
Name:DANIEL R. FERGUSON, MD, P.C.
Entity Type:Organization
Organization Name:DANIEL R. FERGUSON, MD, P.C.
Other - Org Name:BRIGHAM CENTER FOR WOMEN'S HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:435-695-2273
Mailing Address - Street 1:984 MEDICAL DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BRIGHAM CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84302-4712
Mailing Address - Country:US
Mailing Address - Phone:435-695-2273
Mailing Address - Fax:435-695-2278
Practice Address - Street 1:984 MEDICAL DR
Practice Address - Street 2:SUITE 4
Practice Address - City:BRIGHAM CITY
Practice Address - State:UT
Practice Address - Zip Code:84302-4712
Practice Address - Country:US
Practice Address - Phone:435-695-2273
Practice Address - Fax:435-695-2278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5039763-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty